Urinary incontinence (UI) is a common condition characterized by the involuntary leakage of urine. It can range in severity from occasional leakage to a complete loss of bladder control. UI can significantly impact a person's quality of life, leading to embarrassment, social isolation, and reduced self-esteem. There are several types of urinary incontinence, each with its own causes and treatment approaches:
- Stress Incontinence: This occurs when pressure on the bladder increases, leading to leakage of urine. It commonly occurs during activities such as coughing, sneezing, laughing, or exercising. Weakness of the pelvic floor muscles, often due to childbirth, menopause, or prostate surgery, is a common cause of stress incontinence.
- Urge Incontinence: Also known as overactive bladder, urge incontinence involves a sudden and intense urge to urinate, followed by involuntary leakage of urine. It is often associated with an overactive detrusor muscle in the bladder, which contracts involuntarily. Neurological conditions, such as multiple sclerosis or stroke, can contribute to urge incontinence.
- Overflow Incontinence: In this type of incontinence, the bladder does not empty completely, leading to frequent or constant dribbling of urine. It is often caused by bladder outlet obstruction (e.g., enlarged prostate in men) or poor bladder contraction (e.g., nerve damage).
- Mixed Incontinence: Mixed incontinence involves a combination of stress and urge incontinence symptoms.
- Functional Incontinence: This occurs when physical or cognitive impairments prevent a person from reaching the toilet in time, despite having normal bladder function.
Nursing Care Plan for Urinary Incontinence - Assessment, Nursing Diagnosis and Interventions
Assessment
In the assessment, asked when urinary incontinence began to emerge and things associated with symptoms of urinary incontinence:
- How many times incontinence occurs.
- Is there redness, blisters, swelling in the perineal area?
- Is the client obese?
- Does urine dripping between when urinating, if there is how much?
- Does the client incontinence occurs at times that can be expected, such as; when coughing, sneezing laugh and lifting heavy objects?
- Does the client realize or feel the desire for bladder before incontinence occurs?
- How long the client has difficulty in urination / incontinence?
- urine?
- Does the client feel the bladder feels full?
- Whether the client is experiencing pain during urination?
- Is the problem getting worse?
- How do clients cope with incontinence?
Physical Examination
1. Inspection.
- Redness, irritation / abrasions and swelling in the perineal area.
- A lump or spinal cord tumor.
- The presence of obesity or sedentary.
- Bladder distension or tenderness.
- Palpable lump spinal cord tumor area.
- A voice dimmed in the bladder area.
Nursing Diagnosis for Urinary Incontinence
- Anxiety.
- Body image disturbance.
- Knowledge deficit.
- Activity intolerance.
- Low Self-Esteem.
- Impaired Skin Integrity.
Nursing Interventions:
- Maintain cleanliness of the skin, the skin remains in the dry state, changing bed linen or clothing when wet.
- Encourage the client to exercise bladder training.
- Encourage fluid intake of 2-2.5 liters / day if there are no contra-indications.
- Encourage the client to perineal exercises or Kegel's exercise to help strengthen muscular control (if indicated).
- This exercise can be lying, sitting or standing.
- Contract the perineal muscles to stop spending urine.
- Contraction is maintained for 5-10 seconds and then loosen or remove.
- Repeat up to 10 times, 3-4 times / day.
- Check medications taken.
- Check the client's psychological.